Haziner Format
Haziner Format
Haziner Format
HAZINER submitted should be related to member’s workplace. Target for every BU/Dept is 1 HAZINER report per member every month. HAZINER reports to be consolidated in a database and the status of actions
taken kept updated by a SHE champion of the BU/Dept. HIRA Register to be reviewed and kept updated based on the database including the changes made in the workplace based on the HAZINER reports.
Unsafe Condition / Unsafe Act / Near Miss Incident Details Sketch
BU/Dept
Location/ Subsection
In which Activity/Job?
While doing what?
Name & EC
Root Cause (s) to be derived using Why Why Analysis Corrective Action/Preventive Action/Kaizen Content Responsibility Target Date
Sign. of Team Member (Reportee) : Sign. of SHE Coordinator/SHE Champion : Sign. of Team Leader :
FR-74S-51/00/20-05-2015
Severity: 1 – First Aid Case / Potential Near Miss, 2 – Medical Treatment Case / Minor Injury, 3 – Lost Time Injury, 4 – Body Part Loss, 5 - Fatal
S.No. DECA Description Checkpoints
1 A Actuator caught/hit by machine, caught while manually handling material or caught while manually moving MHE
2 B Big contact with Big or heavy objects > 1kg, falling of lifting/access equipment or the objects handled by them
3 C Chemical contact with chemicals
4 D Drop slip, trip & fall of member from height/elevated position/same level
5 E Electrical Electric shock/hazard by equipment/other electrical installation
6 F Fire fire/thermal hazard
7 G Guillotine cut injury by any means
8 H Hit struck by material/struck against fixed structure, hit by MHE that are manually handled, falling of objects <= 1 kg
9 I Industrial Hygiene occupational health, lighting, heat, dust, fumes, noise
10 J Jumbo hit by Powered vehicles Tow truck, BOPT, Forklift, other vehicles, hit by MHE/material towed/handled by the powered vehicles
Assessment Criteria of HAZINER (Hazard Identification & Near Miss Reporting)
S.No. Criteria 5 Points 10 Points 15 Points 20 Points SCORE
1 Severity Low (First Aid/Minor) Moderate (Lost Time Injury) High (Body Part Loss) Very High (Fatal)
2 Frequency Very low frequency job Low frequency job Medium frequency High frequency
(Once in a month) (Once in a week) (Every shift) (many times in a shift)
3 Creativity Parallel deployment Kaizen / Improvement in New concept New concept involving
(of countermeasure taken in the old concept without any additional research
some other equipment/area) additional study
4 Applicability Equipment / process / Applicable to other areas/ Applicable to other Applicable to entire plant
area specific equipment/process BUs/Depts/SBU
within the BU/Dept
5 Countermeasure C/M taken does not address C/M taken addresses the C/M taken addresses the C/M addresses the root
(C/M) quality & the root cause (it can occur root cause root cause (it will not occur cause, adequate, no
Sustenance again), inadequate (it will not occur again), again), adequate and no chance of other incidents
adequate, but chances chance of other incidents happening/creating
of other incidents happening/creating newer newer hazards &
happening / creates hazards but physical automatic indication
newer hazards confirmation required for if C/M failed.
C/M sustenance.